Fluid Therapy

Question 1

Rehydration typically is corrected over 12-24 hours, faster or slower in what cases?

Answer 1

(Renal injury/azotemia and heart disease respectively)

Question 2

What is the typical range maintenance fluid rates for dogs and cats fall into?

Answer 2

(30-60 ml/kg/day, the higher the number the smaller the patient typically, 80-120 ml/kg/day for neonates/pediatrics)

Question 3

(T/F) Dyspnea is one of the later signs associated with fluid overload.

Answer 3

(T, kidneys and GIT are influenced early on in fluid overload → isosthenuria and regurg/ileus/nausea/inappetence)

Question 4

Fluids should be discontinued when a patient no longer needs them (duh) but what does that really mean?

Answer 4

(The patient can keep up with the losses they are experiencing on their own aka they are eating)

Question 5

What are the three fluid compartments of the body?

Answer 5

(Intracellular, interstitial, and intravascular)

Question 6

For the listed electrolytes below, state whether they are high or low in the intracellular fluid compartment:

Sodium
Potassium

Answer 6

Sodium (low)
Potassium (high)

Question 7

For the listed electrolytes below, state whether they are high or low in the extracellular fluid compartment:

Sodium
Potassium

Answer 7

Sodium (high)
Potassium (low)

Question 8

What does the serum sodium concentration reflect if it does not reflect total body sodium content?

Answer 8

(It reflects total body water)

Question 9

What does hyponatremia indicate about total body water?

Answer 9

(There is an excess of water)

Question 10

What does hypernatremia indicate about total body water?

Answer 10

(There is a deficit of water)

Question 11

What is dehydration?

Answer 11

(A slow process, several days to weeks, in which the body pulls water from the interstitium to replace losses in other compartments, which can be replaced slowly)

Question 12

What is hypovolemia?

Answer 12

(A rapid loss of fluid from the intravascular space, one which requires a more rapid restoration of blood volume)

Question 13

Why is the replacement fluid type the same for both dehydration and hypovolemia?

Answer 13

(Bc they both are losses from the same fluid compartment (extracellular))

Question 14

(T/F) Crystalloid fluids are rapidly redistributed into the interstitium.

Answer 14

(T)

Question 15

What are the cons of using crystalloids?

Answer 15

(You have to give a large volume, the effects are transient, and they can potentiate edema)

Question 16

What are the cons of using colloids?

Answer 16

(Interstitial leak and edema formation, changes to coagulation (decreased vWF, VIII, platelet aggregation, and fibrin clot stability), kidney injury, and cost)

Question 17

For the tonicity listed below, compare the salt in the fluids compared to blood:

• Hypertonic
• Isotonic
• Hypotonic

Answer 17

• Hypertonic (fluids have more salt than blood)
• Isotonic (fluids have the same salt as blood)
• Hypotonic (fluids have less salt than blood)

Question 18

Of the following fluid options, state whether they are isotonic, hypertonic, or hypotonic:

• LRS
• Sterile water
• Hypertonic saline
• 0.9% NaCl
• Normosol M
• Normosol R

Answer 18

• LRS (isotonic)
• Sterile water (hypotonic)
• Hypertonic saline (I wonder)
• 0.9% NaCl (isotonic)
• Normosol M (hypotonic)
• Normosol R (isotonic)

Question 19

Why should hypotonic fluids never be bolused and only given at a slow rate (such as maintenance rate)?

Answer 19

(Bc if they are given too fast, there will be too much extracellular water so the body will shove it into the cells and the cells will burst)

Question 20

(T/F) Hypertonic fluids pull free water from both the interstitium and the intracellular space.

Answer 20

(T)

Question 21

Hypertonic saline should be avoided in what types of patients?

Answer 21

(Patients who are dehydrated (bc now we know dehydrated means no water in the interstitium so why would you want to pull more from there) and hypernatremic patients (bc why would you want to give a patient with too much salt more salt))

Question 22

Of the following fluid options, state whether they are balanced or not:

• LRS
• Normosol R
• Normal saline
• Plasmalyte A
• 5% dextrose in water

Answer 22

• LRS (yes)
• Normosol R (yes)
• Normal saline (no)
• Plasmalyte A (yes)
• 5% dextrose in water (no)

Question 23

Of the following fluid options, state whether they should be used for maintenance vs. replacement:

• LRS
• Normosol M
• Plasmalyte A
• D5W
• Normal saline
• Half strength saline

Answer 23

• LRS (replacement)
• Normosol M (maintenance)
• Plasmalyte A (replacement)
• D5W (maintenance)
• Normal saline (replacement)
• Half strength saline (maintenance)

Question 24

For the following fluids, give their tonicity, whether they are balanced or not, and if they should be used for maintenance or replacement:

• Normal saline
• Plasmalyte A
• D5W
• LRS
• Normosol R

Answer 24

• Normal saline (isotonic, not balanced, replacement)
• Plasmalyte A (isotonic, balanced, replacement)
• D5W (isotonic, not balanced, maintenance)
• LRS (isotonic, balanced, replacement)
• Normosol R (isotonic, balanced, replacement)